Joint Sub-Committee on Human Rights relative to Justice and Equality Matters debate -
Wednesday, 9 Dec 2015

UN Convention on the Rights of Older People: Discussion

Chairman

The purpose of this meeting is to have an engagement on the possible need for a new UN convention on the rights of older people. I am very pleased to welcome Mr. Justin Moran, Ms Brigid Sleap and Ms Lianne Murphy. A briefing has been circulated to members. I will invite the witnesses to make a brief opening statement of about five minutes, and we will then have a question and answer session. The witnesses know the system we operate here anyway.

I ask everybody to turn their mobile phones to airplane mode, turn them off or put them outside the door as they interfere with the recording system. I draw the attention of witnesses to the fact that by virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by absolute privilege in respect of their evidence to the committee. However, if they are directed by the committee to cease giving evidence on a particular matter and they continue to so do, they are entitled thereafter only to a qualified privilege in respect of their evidence. They are directed that only evidence connected with the subject matter of these proceedings is to be given and they are asked to respect the parliamentary practice to the effect that, where possible, they should not criticise or make charges against any person, persons or entity by name or in such a way as to make him, her or it identifiable.

Members are reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the House or an official either by name or in such a way as to make him or her identifiable. I call Mr. Moran.

Mr. Justin Moran

I thank the committee on behalf of Age Action Ireland for the invitation to appear today. I would like to briefly introduce my colleagues, Ms. Bridget Sleap from HelpAge International, to which we are affiliated and which has worked to advance the human rights of older people for many years, and Ms. Lianne Murphy, our ageing and development officer.

We are here today because we believe that the rights of older persons are not effectively protected by our current human rights infrastructure and that a new international convention on the rights of older people would go some considerable way towards fixing this. Although many international human rights instruments are universal by nature, older people are rarely specifically mentioned in the instruments themselves or in the recommendations made by the committees established to monitor compliance with them. International human rights law has little to say on issues that are particular to older people, such as elder abuse or support in long-term care. Similar gaps in how human rights law applied to child protection and adoption, for example, highlighted the need for the Convention on the Rights of the Child. A new convention for older people would articulate what human rights law has to say about the issues of concern to them and, if ratified by Ireland, would be directly applicable here.

There are many practical instances in which the rights of older people are not effectively protected here in Ireland. One area of particular concern to Age Action Ireland is the issue of elder abuse, which is a violation of an older person’s right to be free from violence and not to be subjected to cruel, inhuman or degrading treatment. The 2002 report of the working group on elder abuse describes it as "a single or repeated act or lack of appropriate action occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person or violates their human and civil rights". Institutional elder abuse takes the form of not meeting the appropriate care needs of older people within institutional settings. I am sure committee members are familiar with HIQA reports on nursing homes in Ireland which would fit that bill.

An individual example of this is the recent case highlighted in the media of Mr. Gerry Feeney, an 87-year-old man suffering from Parkinson's disease who spent some time in Beaumont Hospital before-----

Chairman

We must not mention names.

Mr. Justin Moran

I beg your pardon. I am sorry about that. In that particular case, the individual was left in a soiled state in public view for several hours. When his incontinence pad came undone he was left exposed on a hospital ward. His family advised that he had been traumatised by his treatment. There are numerous HIQA reports into conditions in Irish nursing homes that highlight similar issues of neglect, and committee members will be familiar with the work done by Deputy Anne Ferris on mandatory retirement, which is also an issue with regard to the right to employment for older people.

I will now ask my colleague, Ms Bridget Sleap, to go into more detail on why we need a new stand-alone convention.

Ms Bridget Sleap

Ageism is a harmful social norm. It has a deeply negative impact on older people's lives and results in their exclusion and marginalisation. Older people throughout the world are subjected to discrimination and denial of rights across every aspect of their lives. Existing international human rights mechanisms are not effectively protecting older people's rights. They lack the necessary specificity on how human rights apply in older age and what attention there is to older people is confined to only a few areas of their lives. As a result, older people remain unaware of their rights and states fail to report on how they are implementing international human rights treaties in relation to them. National legislation protecting rights is often inconsistent across different jurisdictions and this patchwork of protection undermines the universality of human rights. The UN open-ended working group, OEWG, on aging was established in 2010 to identify possible gaps in the existing international human rights framework and how to address them, including through new instruments. After six sessions the working group has reached a consensus that there are serious human rights implementation and protection gaps that need to be urgently addressed.

During the same period we have seen the appointment of a new UN independent expert and the establishment of various regional instruments including the adoption of the Council of Europe's recommendation on the promotion of the human rights of older persons. Most recently, a UN resolution recognised that the diversity of international policies, standards and mechanisms aimed at protecting older people's rights may lead to inconsistent protection as well as gaps in the reporting and monitoring of existing treaty obligations to older people. Adopted by consensus and co-sponsored by a broad range of member states, the resolution reaffirms the mandate of OEWG to discuss and present proposals for a new multilateral instrument.

A new international convention has an advantage over other options in that it would establish universal norms and standards that challenge ageism, prohibit discrimination and promote dignity and autonomy in older age. It would clarify states' human rights obligations and, in doing so, enables us to better understand and claim our rights. It would provide a more effective way to hold governments to account for their human rights obligations. Just as important, it would help change our attitudes towards older people and to older age, including our own, to see it as a time of continued human flourishing rather than just a time of loss and decline. This would be transformative and something that generic human rights instruments have failed to do.

Senator Katherine Zappone

I thank the witnesses for their presentation. As they may be aware, the Seanad has a public consultation committee and our first report, a few years ago, was on the rights of older people. We recommended movement towards the development of a treaty for older people at UN level. I am on record as being in favour of that, and our colleagues in the centres of disability and human rights at NUI Galway have been working in this field. One of the things we learned during the consultation was that, in the process of moving towards a UN treaty on the rights of older people, the EU group of which Ireland was a part was not in favour. Maybe it was not that they were not in favour but that they were unconvinced of the need for it. They spoke about treaty fatigue and asked whether we needed another treaty on the rights of another group of people. Can the witnesses update us on where the negotiations are in respect of the EU group feeding into the UN? The witnesses referred to the UN open-ended working group on aging.

Ms Bridget Sleap

The EU's common position at the OEWG has remained consistent throughout the six sessions. It has not ruled out the possibility of a convention but it has said it wants to see existing instruments implemented.

Slovenia, an EU member state, has now come out in favour of a convention, and we have heard that a significant event coming up is the report of the independent expert in September 2016. Although it is to the human rights council and is, therefore, separate, the outcome of the report on the extent to which existing instruments are being implemented effectively will have a significant impact on some member states' positions, and this may affect the EU position. There is a diversity of opinion beneath the common EU position and it may well be affected by the independent expert's report. Some of the arguments they are using, such as treaty fatigue, are similar to the ones used in the discussion on the convention on the rights of persons with disabilities before the drafting stage.

Senator Katherine Zappone

What, if anything, could our committee do to support the process, especially through Ireland's contribution to the EU group?

Mr. Justin Moran

As well as meeting this committee, one of the reasons Ms Sleap is here today is to meet representatives of the Department of Foreign Affairs and Trade and the Irish Human Rights and Equality Commission to present our arguments. We hope the sub-committee will raise with the Department of Foreign Affairs and Trade the need for Ireland to take a more positive stance in the OEWG. As Ms Sleap said, Slovenia has taken a more positive stance than other EU member states. In November a resolution, co-sponsored by a number of EU member states including Austria and Croatia, was passed at the United Nations agreeing that gaps in human rights law protection existed. A move in the EU common position, though very slow and gradual, is taking place. Any pressure that the sub-committee could bring to bear on the Department of Foreign Affairs and Trade to support that would be very welcome.

Senator Katherine Zappone

Is Age Action Ireland working with the Irish Human Rights and Equality Commission?

Mr. Justin Moran

We are meeting them today to talk about this as part of a series of scheduled events. They are not involved in the piece of work we are doing at UN level, but we will be briefing them on the progress of the convention.

Deputy Finian McGrath

I welcome Justin, Bridget and Lianne. Mr. Moran said the rights of older persons were not effectively protected in our current human rights infrastructure and that a new international convention on the rights of older people would go a long way towards fixing this. How does one move from the convention, and its principles and ideals, to practical support for older people on the ground? We respect the rights of older people, but many of them, particularly those on their own, do not have the necessary supports on the ground.

How does that lead towards providing practical services for these older people?

Mr. Justin Moran

There are two issues here, the work Age Action is doing on a daily basis to try to improve the services and protections that are available to older people, and the programmes and policies the Government is implementing. That work will continue but in the long term we believe a convention on the rights of older people would be very helpful in terms of protecting those human rights. Once the convention is passed, and obviously there is no draft text for the convention at present, the issue then would be to hold the Government to account in delivering on those commitments. For example, Ireland has made commitments regarding another international treaty, the International Covenant on Economic Social and Cultural Rights. Ireland has signed and ratified that treaty. We can use that treaty mechanism to try to hold Ireland to account in delivering on those rights and to put attention on the national and global scale of the failures or successes of the Government in terms of delivering on those human rights commitments. In terms of a practical difference, if a person in Cork, for example, cannot get home help, an international convention, if it was ratified tomorrow, would not necessarily change that, but we believe a convention would be very important in terms of changing it over the long term and challenging issues of ageism and discrimination and giving us something which we can use to hold future Governments to account.

Deputy Finian McGrath

It is all very well to have United Nations and other conventions on it but we must have the practical results of those conventions on the ground so that our older people see those services as a right. That is the problem I have with many organisations. Returning to the second question on institutional elder abuse, I have come across this recently in my local constituency. From Age Action's experience, is that a widespread issue in nursing homes, hospitals or institutional settings? Is this the experience of members of Age Action who work directly with older people or is it that every now and again it finds an isolated case?

Mr. Justin Moran

Specific references to elder abuse are reported to the Health Service Executive and monitored. Last year, 2,600 cases were reported. The most common form of abuse was psychological, the next was financial while physical made up about 300 to 400 of those cases. That 2,600 is the highest number that has ever been reported since elder abuse reporting began in 2007. Our own experience from speaking to people who contact us and raise issues of elder abuse with our information service is an enormous reluctance on the part of people to bring forward these cases. In many situations, if it is a family member, as the majority of elder abuse cases are, they simply do not want to get a family member in trouble. They do not want to get the Garda or the HSE involved in family situations. In institutional settings, it can be a concern over the repercussions of raising those issues. The problem with elder abuse is the lack of reporting of it. The fact is that many older people do not categorise necessarily what is happening to them as elder abuse in the first place. That is why we are trying to encourage people, and we encourage our members and anybody who contacts us, to refer these cases and these situations to the HSE who have case workers dedicated to working on the issue of elder abuse.

Deputy Finian McGrath

Does Mr. Moran have up-to-date figures on institutional abuse?

Mr. Justin Moran

I can get those for the Deputy. I do not have them with me.

Deputy Finian McGrath

Perhaps they could be sent to the clerk.

Mr. Justin Moran

Yes.

Deputy Finian McGrath

I wish to put a question to Ms Bridget Sleap, who said ageism is a harmful social norm. She talked about exclusion and marginalisation but I would go one step further and say that ageism and the damage it does to older people and senior citizens shortens their lifespan. I know many former colleagues, from my previous life as a school teacher, who retired after 40 years service and within a year or two of retiring a very high percentage had died; that was in the past 20 or 30 years. If ageism is allowed to develop, it will shorten the lifespan of many older people who have much to contribute to society, whether they move on to a new career or get involved in some other way. That ageism can lead to the death of many good people who want to contribute to society and their country. Would the witness agree with that statement or is it too harsh?

Ms Bridget Sleap

Certainly it reminds me of some research that is being done at Yale which looked at the very negative images of older people on television and in the media and how that had a negative impact on people's health and their wellbeing. There is, probably, evidence to support the relationship between ageism and physical health. HelpAge International is a member of a coalition of organisations. We did a consultation across 50 countries and asked older people how being treated differently and discriminated against affected them. They said they were made to feel incompetent, that they were useless and that they were a burden on society. This had a huge impact on their mental wellbeing as well. I think it can be harmful in many different ways.

Senator Ivana Bacik

I thank the witnesses for the presentation. Following on from some of the responses to other colleagues, I am interested to note that the impact of the convention would be more likely to be long term and would have symbolic and declaratory effect. I am interested in the substance of it. Mr. Moran said there is no draft text but I assume that work has been done at international level on the content and the substantive rights guaranteed in it. Can the witnesses outline some of those or the shape of that convention in some way to give us a better sense of it?

Ms Bridget Sleap

Certainly we could also look to some of the work at a regional level that is being done. An inter-American convention on the promotion of the human rights of older persons was adopted this year and a draft protocol to the African charter on human and people's rights is up for adoption in January. It is interesting that we can look at those to get a sense of what some of the substantive content might look like and also at the UN open-ended working group. There is a mix of standards in other international treaties and how they specifically apply in the context of older age and specific measures that states could take to meet their obligations. That is specific articulation. The area of elder abuse has already been discussed. There is also the right to palliative care and long-term care. These areas of rights that are, perhaps, unique or particular to older age have not been articulated elsewhere but are generated from our interpretation of other rights such as the right to health, social security and social protection.

Senator Ivana Bacik

I thank Ms Sleap. That is very helpful. What is the most relevant regional or other text from which an international convention would draw if we wanted to look at a resource to understand that?

Ms Bridget Sleap

I think the two I have mentioned and also the Council of Europe's recommendation. They are all of equal importance. I do not think any one should be used as a particular model. All of them would be relevant.

Deputy Anne Ferris

I welcome the delegates and commend Age Action Ireland on its work. I know it only too well from our hearings on the abolition of the mandatory retirement age. The important question for us today as a sub-committee is how we can help with the open-ended working group to get the whole issue further on the agenda and what the Government can do. In that context the Department of Foreign Affairs and Trade was mentioned. Is the Department of Foreign Affairs and Trade working on this issue?

Mr. Justin Moran

I can only imagine that the Department of Foreign Affairs and Trade would have been allocated lead responsibility for this as an international treaty as part of international negotiations. A treaty like this cuts across so many other Departments and many different policy areas. I am sure committee members are conscious of the fact that once it is the responsibility of one Department, the other Departments say it will take care of that and will push that forward and as it is an international negotiation, the Department of Foreign Affairs and Trade is taking the lead.

We hope the Government will push the EU position forward or possibly consider going beyond it, as Slovenia has done, by supporting a convention on the rights of older people. The EU action plan on human rights and democracy commits the European Union to increasing awareness of human rights and the specific needs of older people, paying particular attention to age-based discrimination. There is commitment at EU level, but the difficulty, as Ms Sleap touched on earlier, is not that they are opposed to a convention, rather that they are not necessarily convinced of its merits. The obligation on organisations such as Age Action and HelpAge is to provide legislators and Departments with information and evidence to support the need for a new convention. We hope legislators will use their positions to write to Ministers and raise these as topical issues in the Dáil or Seanad to make sure it is taken seriously by the Department and moved forward. That is what we are looking for today.

Deputy Anne Ferris

The sub-committee should make a recommendation to contact the Minister for Foreign Affairs and Trade on the issue. We often hear that legislation and actions need to be equality approved and in this context we often think of gender and disability rather than older people. The culture of respect for older people has changed. When I was growing up, we called our neighbours Mrs. Coffey, Mrs. Byrne or Mrs. Butler; we never called people by their first name. There has been a shift in our culture and there is not the same respect for older people that there was 20 or 30 years ago. Organisations like Age Action are very important. I know from reading the newspapers and from Age Action's publication that it looks at every single aspect of life and equality proofing regarding older people.

I thank the witnesses for coming here today. It is a very important issue. The sub-committee should agree to ask Senator Zappone to contact the Minister for Foreign Affairs and Trade and any other Department to support the convention.

Mr. Justin Moran

I will respond briefly to the points the Deputy made about culture by noting something positive the committee might not be aware of. Age Action recently carried out research to look at the issue of interculturalism in nursing homes and residential care settings. It looked in particular at care workers who were born outside of Ireland and one interesting thing was the positive experience of many nursing home residents because of the respect for older people and aging that exists in the cultures of such workers. Perhaps that respect has been eroded somewhat in Ireland but if the convention or suggestions that are being made to tackle ageism will help restore it, it is worth doing.

Deputy Fergus O'Dowd

I apologise for being late; the traffic was heavier than I expected. I welcome the presentation and I have a number of questions. As a public representative, I do a lot of work on the care of older people, particularly institutional and long-term care. There are significant issues.

Chairman

There is a phone on somewhere. Something is buzzing.

Deputy Fergus O'Dowd

I apologise. One of the key issues is that there are privately run nursing homes and a public-run HSE system. If I was being abused in a public nursing home, the HSE has power and authority, but if it was a private nursing home, I would go first of all to the nursing home owner, make her call the manager and make my complaint, after which nothing would be done. I have come across hundreds of complaints through HIQA, all of which were typed up and recorded beautifully, yet nothing happened. There is significant abuse. I have given a file with over 900 cases of abuse - some very minor, others very serious - to the Garda, which is looking at the issue. The Ombudsman got involved and since the end of August 2015 the Ombudsman is a notice party to all complaints made, which I welcome.

The rights of people in institutional care is a huge issue. The problem is that if people are in a home, they are afraid to complain because they may be put out. There is significant evidence of people being excluded or put out of nursing homes because they or their family complained. There is also a huge issue of people not being allowed into a nursing home because they have serious medical problems such as dementia. There are allegations that some nursing homes cherry pick their residents and will not take a person with dementia.

In some states in America, the residents of nursing homes have a bill of rights, which are aspirational. It may include eight or ten rights, such as the right to be treated properly and with respect and not be abused. We need to move into the area of affirming the rights of people particularly those in institutional care. I acknowledge the significant increase in the quality of care in private and public nursing homes in recent years. What further steps should be taken, particularly in institutional care, to vindicate the rights of people and protect them when they wish to make complaints?

Dementia care is a huge issue. If I open a private nursing home, I should be obliged to accept people suffering from dementia and to have a strategy to deal with it, depending on the number of beds I have. It is a significant issue. I hope I am not asking too many questions.

Chairman

How would a UN Convention on the rights of older persons impact on the rights and issues raised by Deputy O'Dowd? I think the witness said it will not happen today or tomorrow but these issues are crucial and the convention would be global and overarching. How will it impact on the issues raised by the Deputy?

Deputy Fergus O'Dowd

There is no point in having aspirations if we do not have the backup or fire power to sort these people out.

Chairman

It has to filter down.

Deputy Fergus O'Dowd

I am trying to find a model that actually works. I preface all my comments with my acknowledgement of the significant improvements in quality of care but there are very significant abuses - sexual, financial, emotional and family. There are huge problems which we need to address. I am also concerned with the issue of dementia care. More and more people will suffer from dementia because people will live longer. The question of dementia-friendly cities, towns, policies and departments is important. We need to shake up the whole system from its roots. The issue is respect for everybody. We have gay rights, gender rights and employment rights, yet we do not have enough dementia-focused policies. We need to drive that agenda.

Chairman

I will let Mr. Moran reply here.

Deputy Fergus O'Dowd

Will Mr. Moran indicate, from the research, the areas where there have been significant advances?

Chairman

The abuses that Deputy O'Dowd has raised are illegal. Abuse, whether sexual, physical or financial, would be the subject of criminal investigations. Such abuse is very serious and probably covered already under statute. Will Mr. Moran link those issues to today's theme, which is the UN convention, rather than getting into specifics?

Deputy Fergus O'Dowd

I acknowledge that the Chairman understands my point. It is all very well to have aspirations, if all these abuses are happening underground.

Chairman

Give Mr. Moran a chance to answer.

Mr. Justin Moran

To reference briefly a point the Chairman made on the global nature of the convention, because it has not really come up in conversation, we will speak primarily about how the convention could apply in Ireland in the type of residential care settings mentioned. It is also important to reflect for a moment on the fact that the convention would apply globally. The majority of older people throughout the world do not have a state pension, and we are fortunate in some ways it is here. It is important to look at the benefit it would have in various contexts.

I agree with Deputy O'Dowd's comments. We cannot wait for an international convention on the rights of older people to sort out the problems happening in our nursing homes and residential settings. If and when the convention comes together, we would like it to contain provisions which enable older people to stay at home, as many do not want to be in a nursing home and many do not need to be there in the first place. We would also like it to include provisions on their right to a home, their right to choose where to age and the right to age with dignity. If and when these rights are written into a convention, and when the convention is signed and ratified by Ireland, it will make a difference to older people in nursing home and residential settings. However, that is down the line and people are in this situation now. I am happy to speak to the Deputy about this in more detail after the meeting.

We receive numerous complaints to our information line on care and situations in nursing home settings. One of the most common is about nursing home residents being charged by private nursing homes for services they do not, and in many cases cannot, use.

Deputy Fergus O'Dowd

Yes.

Mr. Justin Moran

In the review of the fair deal scheme published earlier this year, the focus of the debate was very much on payment and how much residents would pay. It made an enormous number of recommendations on improving services and enabling residents to take control and have a little influence over nursing home situations. There are supposed to be nursing home residents' committees. How many are there, how do they operate and are they listened to or just talking shops? These are some of the discussions we need to have.

Ms Sleap will speak on the issue of dementia.

Ms Bridget Sleap

One of the issues raised which the convention would address, which has perhaps not been addressed enough to date, is intersectional discrimination with regard to someone living with dementia. This is with regard to the intersection between older age and dementia. The convention should contain a clear prohibition on age discrimination and recognition of this intersectional multiple discrimination. This would expose and address some of the issues being described.

The convention would add to recognising the rights of people in residential or other care settings. There are some voluntary charters which look at the rights of people with dementia. There is one in Scotland. There are also such charters with regard to the rights of residents in care settings. There is a European charter on the rights and responsibilities of people in long-term care. These are just voluntary charters and a convention would bring a legal obligation to them. It would also recognise the third-party obligation of states to address the issue of public and private settings, whereby states have an obligation to protect and respect the rights of people in private settings where the services are provided by private actors as well as by public service providers.

Chairman

The Oireachtas Select Committee on Foreign Affairs and Trade is voting and I want to bring it to the attention of anyone who is a member of that committee. I apologise for interrupting.

Ms Bridget Sleap

I have finished.

Senator Katherine Zappone

This has been a brilliant discussion. I wish to comment on the issue of how a UN convention would ultimately help. The witnesses spoke about the provision of services and providing support to older people in their community. The discussion we are having clearly indicates we have a long way to go to protect the rights of older people, whether with regard to mandatory retirement age, long-term residential care issues, dementia care or elder abuse, which was also raised in the presentation. My reflection with regard to the question raised initially by Deputy McGrath, to which the Chairman has brought us back, is how, ultimately, the convention would result in practical supports. It may not be so far down the road because in the process of encouraging Ireland to support the development and writing of a convention, there could be much advocacy and awareness raising in this regard. The most important aspect is that there could be a parliamentary conversation on what it would mean, why we would need it and where there are gaps, as well as perhaps a national conversation, which would raise a focus on the rights of older people in a way there has not been before. This might make us create different laws and policies in the process of getting to the convention.

If we do get a convention, and I hope we do, we would have international law to which we must pay attention in our domestic lawmaking and policy-making. One of the problems, which is why this committee is so important and why we fought so hard to get it established, is that often parliamentarians are not part of the conversation to see how well we do in monitoring these international laws. The committee tried to examine whether we could have a part to play in supporting the Department of Foreign Affairs and Trade and the Department of Justice and Equality in the ratification of the international convention on the rights of people with disabilities. We were told we could not do so because the law would have to be changed. Who is doing this then? It is various Departments and civil servants. I am not saying they are not doing a great job, but parliamentarians are not engaged in the conversation. When we are not engaged in the conversation, we do not understand how international law on human rights can help us in our law making to achieve more quickly better long-term residential care or support to people in the community.

In response to Deputy Ferris's question on what we can do, we would probably have to write to the Minister for Justice and Equality to write to the Minister for Foreign Affairs and Trade because this is a justice sub-committee. We could support the witnesses in encouraging Ireland and the Department of Foreign Affairs and Trade, which again raises the question why it should be left to that Department, to see the merits in such a convention. This is the whole point, and the better parliamentarians understand what the merits might be, the better we can encourage this. That was a comment.

Chairman

I was wondering where the Senator was going with it.

Senator Katherine Zappone

That is why it is so brilliant that-----

Chairman

Maybe we can get a comment back from Mr. Moran.

Mr. Justin Moran

I agree strongly with the Senator. With regard to engagement with legislators, if we look at the points Deputy O'Dowd raised earlier, legislators have practical first-hand experience and knowledge through dealing with constituents, community groups, residents' groups and disability groups, and if this knowledge is not involved in the discussions on international human rights treaties we have the issue we have discussed several times, which is them happening very far away but not really having a practical impact for somebody looking for home care in Cork or a nursing home in May. If the gap is there, it will not be resolved unless people with experience are involved in it. Age Action Ireland and NGOs represent older people and people in these settings so we can do some of it, but legislators, politicians and elected representatives are very familiar with it and can bring a level of experience to it.

Comments were made on how the discussion itself could bring about change. We speak about conventions and treaties, but change comes from changing mindsets. Unless we have a changed mindset, and an understanding of seeing older people as individuals with human rights and an understanding of how this makes a practical difference, we will not get the convention. This is where the discussion and the debate, either a parliamentary debate or a national debate, is important. It is only when minds are changed that people will open up and start to think perhaps we should look at a convention and consider these options and possibilities. The debate itself will help to change minds, and in doing so will, hopefully, have a knock-on effect on how people create policy today, whether in the Department of Health or the Department of Justice and Equality. If they are forced to be part of these debates and must engage it will, hopefully, have a knock-on effect on how they deliver services and programmes on a daily basis.

Deputy Finian McGrath

Ms Murphy spoke about respect, and how older people were treated in the past and how they are treated today.

I think the situation has deteriorated badly and there is a lack of compassion and support among broader society for many older people. Some of the situations we discovered in terms of human interaction would not have happened to older people 30 years ago. I think it has got worse.

I am asking for examples of good practice. Age Action is working with sister organisations in 76 countries across the world. Have the witnesses come across a couple of countries that have got both the rights aspect for older people and the services and societal supports on the ground right? In our context, I have come across a recent example of best practice from a very unlikely source for many people. The way the Traveller community, which is an ethnic group in this country, treats its senior citizens and older people is amazing. They have a tradition within their community of ultimate support and respect for the older generation. It is something from which we, as a broader society, could learn. From Age Action's point of view, it is working very closely right across 76 countries. Which one or two have it right or which country has it near enough to right?

Ms Bridget Sleap

Rather than single out one country, we have seen that where, for example, older people's right to a pension has been realised with the introduction of non-contributory social pensions, this can have an incredible impact on the respect and value Deputy McGrath is talking about. There is evidence from South Africa, for example, which has a near-universal non-contributory pension, that this has had an impact on the way older people are respected. While very different from Ireland, that context also involves economic migration and the impact of HIV and AIDS in changing family structures. Traditional support systems are also changing. There is evidence that when older people's rights are respected, this can have an impact on the broader way we live together in society.

Mr. Justin Moran

We can look at some countries that are good examples in different areas. For example, we were looking at sheltered housing recently and examples of this in Britain, the Netherlands and Germany, some of which are very innovative. There is a sheltered housing project in the Netherlands, for example, that allows people to group on the basis of culture. There are both good and bad sides to this. It means there is a group of people together who may be very devout in their religious beliefs, so sheltered housing is provided that reflects and enables those belief. In other cases, it may be a hobby and sheltered housing may be provided for people with particular interests. Innovative work has been done on specific issues. The problem is that what Deputy McGrath is looking for is a one-size-fits-all approach, although that phrase is flippant. He is looking for something that looks at it as a whole and, unfortunately, I do not think there is a country that does that. If he wants to discuss countries that do sheltered housing or state pensions better than Ireland, we can do that. There are countries that do that. We are looking for a country that looks at the culture of older people and that understands, respects and enables it. It is a search that we are-----

Deputy Finian McGrath

The poorest countries in South America or Africa have more supports and services for the elderly than some of the so-called rich, affluent western countries. That is the reality.

Mr. Justin Moran

In many cases the reason for that is that the community, the family and the group step in to replace the lack of a state. I briefly touched on the point earlier that in many countries there is no state pension. When there is no income like that, people step in to look after older people, take care of them and support them. That can have its own negative aspects, whereby the older person is just seen as a burden. People think they have to care for them because the state is not there. What we need is an approach that sees older people not as a burden, vulnerable or dependent but as people in their own right, and which approach enables them to continue to participate in their community, whatever kind of community that might be.

Chairman

A number of questions arise. The issue of culture and mindset is coming up repeatedly. I remember meeting someone from South Korea a few years ago. They said their culture had been such that older people were respected hugely. The eldest son in the family had the responsibility of minding the parents and looking after them, but that was changing a little there at the time and they were concerned about that. It is a moving thing. We use the term "older people" rather than "the elderly", which is a little more objective than subjective. A good friend of mine said to me at one stage that she would not go into a nursing home because they were all old people in there, and she was 95. There are people who are old and who are 55 and I know people who are very active and young at heart at 85. A good friend of mine is 85 and he is just amazing. How does one define older people?

Deputy Finian McGrath

Once one reaches 60.

Chairman

One is in trouble.

Ms Bridget Sleap

What the Chairman has illustrated are the challenges with defining older people by a single chronological age. It varies so much, and also in terms of our attitudes. In 2012, there was a Eurobarometer survey across Europe, which looked at the age at which people across different countries, genders and groups thought old age began. It varied hugely, from early 50s to mid-70s. For the purposes of a convention, looking at a single chronological age definition will not be that helpful because it will not capture the levels of ageism and discrimination that people experience at different ages. The Chairman has highlighted one of the key areas of debate around a convention and its purpose.

Mr. Justin Moran

The definition will continue to change as we live longer. The State pension kicks in at 66 and there was a time when one might have expected to live into one's late 60s and early 70s. We are going to be living into our 80s and 90s, which is something to be celebrated. It is often seen as the pensions time bomb, but it is one of the biggest success stories globally over recent years that people are living longer and healthier lives. Therefore, the definition of old age is going to change as we live longer, healthier and more active lives.

Chairman

The average life expectancy in Ireland for men is 78 and for women it is 82. It has been going up quite a bit over recent decades. Is the need for proactive respect and support, rather than passive respect and support, something this convention might bring about, that people might begin to think more positively and in a more focused way about support? Living with dignity is also included, along with empowerment of older people. Sometimes people go into nursing homes or hospitals and they are disempowered. What Deputy O'Dowd brought up touched on it quite a bit. The idea of residents' committees, which were mentioned, brings back the power to the residents in these places. Will the witnesses comment on the issue of proactive respect and empowerment of people?

Ms Bridget Sleap

That is something we would want to see run through the convention in its entirety, from the types of measures that are necessary to realise the rights of older people to the reporting and monitoring mechanisms and ensuring older people are included in the national monitoring bodies. It is central.

Mr. Justin Moran

There is also work to be done regarding educating people in those human rights and giving them the power and authority to claim them. It is all very well telling nursing home residents that they have a right to a residents' committee and a right to stand. One has to explain that to them and to support and empower them. There is substantial work to be done. Any time I have dealt with international human rights law, there has always been the suggestion that the job is done when one gets the treaty. The major work comes after that in terms of enabling people to campaign for their human rights, empowering them to do so and ensuring governments realise the treaty is just the beginning of the work. They must then push this forward and, in a proactive way, deliver the necessary legislative change.

Chairman

Cultural change with the public's support is important. That matter arises often.

Deputy Finian McGrath

I commend the witnesses. This has been a good debate. It is a pity that it is not being held in the Dáil Chamber, as many ideas have been floated at this meeting. All politicians agree that older people's trump card is the power of voting. Every Deputy is conscious of the fact that many older people are guaranteed to use that power. As their representatives, the witnesses should encourage it because they are an important part of the democratic process and can use their clout to push the issues for which the witnesses are fighting. We will listen.

Deputy Fergus O'Dowd

I welcome everything that has been stated. The convention is excellent and will be ground breaking, but we as a country must vindicate each and every one of those rights and, from a political perspective, invest responsibility in one Minister or Department to ensure that all agencies do so and all policies are proofed as regards older people.

The most important point that I can make is that approximately one in ten people in our society has cognition problems, for example, an inability to understand or communicate effectively because of disability or dementia. Dementia-friendly cities and towns are key to vindicating people's rights. A major problem is that, if one has dementia, one cannot vindicate one's rights because, by definition, one is not in control of one's own life. This significant issue must be addressed. We can write all of this down, print it in glossy booklets and circulate those, but unless someone is driving the agenda, nothing will happen.

Chairman

The capacity Bill that is being finalised in the Houses will address much of what Deputy O'Dowd has mentioned. It is challenging legislation, but it is almost through the Houses and will be a major game changer as regards dementia, rights, legal capacity and so forth. Do the witnesses have further comments to make?

Mr. Justin Moran

No.

Ms Bridget Sleap

No.

Chairman

All done. I thank the witnesses for attending. It is a most interesting, challenging and important topic. As Deputy Ferris stated, we must consider lending our support to it. I get the sense that this is just the beginning, though, as there remains a great deal of work to be done in the public realm - to change people's mindsets and get them thinking and focusing on this - and internationally. We are probably not the worst country in the world by any means, but this will have an impact globally, so it is important from that point of view.

Mr. Justin Moran

We thank the committee.

The joint sub-committee went into private session at 11.03 a.m. and adjourned at 11.10 a.m. sine die.